{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:49:47Z","timestamp":1791348587932,"version":"4.3.1"},"reference-count":46,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: The Mediterranean Diet (MD) has gained attention for its potential benefits in enhancing athletic performance and overall health. This systematic review aims to evaluate the effects of the MD on athletic performance, strength, body composition, and metabolic markers in both athletes and non-professional athletes. Methods: The review included seven studies with a total of 116 participants, ranging from professional handball players to non-professional strength athletes. The studies assessed various aspects of athletic performance, including strength, power, endurance, and body composition. Results: The main key findings from the review showed that MD may improve muscle endurance and power, as well as anaerobic performance in CrossFit athletes, and MD was associated with enhanced strength performance, including increased vertical jump height, hand grip strength, and shuttle run performance. The results on the impact on body composition were mixed, with some studies showing improvements in fat-free mass and skeletal muscle mass, while others found no significant changes. The MD also demonstrated positive effects on several markers, such as increased plasma total antioxidant activity and decreased markers of oxidative stress and inflammation. Conclusions: In conclusion, while the MD seems to represent a viable dietary strategy for enhancing athletic performance and overall health, more rigorous studies are necessary to clarify its impact across diverse athletic populations.<\/jats:p>","DOI":"10.3390\/nu16203454","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T06:46:33Z","timestamp":1728888393000},"page":"3454","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Impact of the Mediterranean Diet on Athletic Performance, Muscle Strength, Body Composition, and Antioxidant Markers in Both Athletes and Non-Professional Athletes: A Systematic Review of Intervention Trials"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7915-7585","authenticated-orcid":false,"given":"Ellis","family":"Bianchi","sequence":"first","affiliation":[{"name":"Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal","family":"Erbasan","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-7257","authenticated-orcid":false,"given":"Patrizia","family":"Riso","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Perna","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1017\/S1368980013003169","article-title":"Mediterranean Diet and Health Status: An Updated Meta-Analysis and a Proposal for a Literature-Based Adherence Score","volume":"17","author":"Sofi","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9139","DOI":"10.3390\/nu7115459","article-title":"Definition of the Mediterranean Diet; A Literature Review","volume":"7","author":"Davis","year":"2015","journal-title":"Nutrients"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/joim.13333","article-title":"The Mediterranean Diet and Health: A Comprehensive Overview","volume":"290","author":"Willett","year":"2021","journal-title":"J. Intern. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"112121","DOI":"10.1016\/j.exger.2023.112121","article-title":"Mediterranean Diet in the Management and Prevention of Obesity","volume":"174","author":"Dominguez","year":"2023","journal-title":"Exp. Gerontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1017\/S0007114521003202","article-title":"The Mediterranean Dietary Pattern for Optimising Health and Performance in Competitive Athletes: A Narrative Review","volume":"128","author":"Griffiths","year":"2022","journal-title":"Br. J. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kaufman, M., Nguyen, C., Shetty, M., Oppezzo, M., Barrack, M., and Fredericson, M. (2023). Popular Dietary Trends\u2019 Impact on Athletic Performance: A Critical Analysis Review. Nutrients, 15.","DOI":"10.3390\/nu15163511"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101395","DOI":"10.1016\/j.arr.2021.101395","article-title":"Cross-Sectional and Longitudinal Associations between Adherence to Mediterranean Diet with Physical Performance and Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis","volume":"70","author":"Trichopoulou","year":"2021","journal-title":"Ageing Res. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"99","DOI":"10.26444\/ms\/175704","article-title":"The Power of Ketogenic Diet in Physical Performance\u2013Review of the Latest Research","volume":"26","author":"Martyka","year":"2024","journal-title":"Environ. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s12603-015-0588-7","article-title":"Association between the Mediterranean-Style Dietary Pattern Score and Physical Performance: Results from TRELONG Study","volume":"20","author":"Mazzuco","year":"2016","journal-title":"J. Nutr. Health Aging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jand.2015.12.006","article-title":"Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance","volume":"116","author":"Thomas","year":"2016","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kerksick, C.M., Wilborn, C.D., Roberts, M.D., Smith-Ryan, A., Kleiner, S.M., J\u00e4ger, R., Collins, R., Cooke, M., Davis, J.N., and Galvan, E. (2018). ISSN Exercise & Sports Nutrition Review Update: Research & Recommendations. J. Int. Soc. Sports Nutr., 15.","DOI":"10.1186\/s12970-018-0242-y"},{"key":"ref_12","unstructured":"Scalfi, L., Censi, L., Marra, M., Maffeis, C., Pecoraro, P., Polito, A., Strata, A., Tagliabue, A., Brighenti, F., and Acquistucci, R. (2014). LARN Livelli di Assunzione di Riferimento di Nutrienti ed Energia per la Popolazione Italiana. IV Revisione, ITA."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104500","DOI":"10.1016\/j.jff.2021.104500","article-title":"Effects of Dietary Fiber on Glycemic Control and Insulin Sensitivity in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis","volume":"82","author":"Mao","year":"2021","journal-title":"J. Funct. Foods"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14522","DOI":"10.18632\/aging.203051","article-title":"Effects of Exercise on Cellular and Tissue Aging","volume":"13","author":"Carapeto","year":"2021","journal-title":"Aging"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Thirupathi, A., Wang, M., Lin, J.K., Fekete, G., Istv\u00e1n, B., Baker, J.S., and Gu, Y. (2021). Effect of Different Exercise Modalities on Oxidative Stress: A Systematic Review. BioMed Res. Int., 2021.","DOI":"10.1155\/2021\/1947928"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1249\/JSR.0000000000000729","article-title":"Polyphenols: Potential Beneficial Effects of These Phytochemicals in Athletes","volume":"19","year":"2020","journal-title":"Curr. Sports Med. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1093\/eurpub\/cky113","article-title":"Mediterranean Diet and Health Outcomes: A Systematic Meta-Review","volume":"28","year":"2018","journal-title":"Eur. J. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1093\/advances\/nmaa050","article-title":"Are There Benefits from the Use of Fish Oil Supplements in Athletes? A Systematic Review","volume":"11","author":"Lewis","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1152\/japplphysiol.00622.2016","article-title":"Recovery of the Immune System after Exercise","volume":"122","author":"Peake","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1007\/s40279-015-0323-x","article-title":"Impact of Dietary Antioxidants on Sport Performance: A Review","volume":"45","author":"Braakhuis","year":"2015","journal-title":"Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1249\/JSR.0000000000001083","article-title":"Vitamin C Supplementation and Athletic Performance: A Review","volume":"22","author":"Rogers","year":"2023","journal-title":"Curr. Sports Med. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Miralles-Amor\u00f3s, L., Asencio-Mas, N., Mart\u00ednez-Olcina, M., Vicente-Mart\u00ednez, M., Frutos, J.M.G.-D., Pe\u00f1aranda-Moraga, M., Gonz\u00e1lvez-Alvarado, L., Y\u00e1\u00f1ez-Sep\u00falveda, R., Cort\u00e9s-Roco, G., and Mart\u00ednez-Rodr\u00edguez, A. (2023). Study the Effect of Relative Energy Deficiency on Physiological and Physical Variables in Professional Women Athletes: A Randomized Controlled Trial. Metabolites, 13.","DOI":"10.3390\/metabo13020168"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Caparello, G., Galluccio, A., Ceraudo, F., Pecorella, C., Buzzanca, F., Cuccomarino, F., Bonofiglio, D., and Avolio, E. (2023). Evaluation of Body Composition Changes by Bioelectrical Impedance Vector Analysis in Volleyball Athletes Following Mediterranean Diet Recommendations during Italian Championship: A Pilot Study. Appl. Sci., 13.","DOI":"10.3390\/app13052794"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1123\/ijsnem.18.3.301","article-title":"High-Protein-Pufa Supplementation, Red Blood Cell Membranes, and Plasma Antioxidant Activity in Volleyball Athletes","volume":"18","author":"Malaguti","year":"2008","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chilelli, N., Ragazzi, E., Valentini, R., Cosma, C., Ferraresso, S., Lapolla, A., and Sartore, G. (2016). Curcumin and Boswellia Serrata Modulate the Glyco-Oxidative Status and Lipo-Oxidation in Master Athletes. Nutrients, 8.","DOI":"10.3390\/nu8110745"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"762","DOI":"10.4162\/nrp.2023.17.4.762","article-title":"Effect of a Mediterranean-Style Diet on the Exercise Performance and Lactate Elimination on Adolescent Athletes","volume":"17","year":"2023","journal-title":"Nutr. Res. Pract."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ficarra, S., Di Raimondo, D., Navarra, G.A., Izadi, M., Amato, A., Macaluso, F.P., Proia, P., Musiari, G., Buscemi, C., and Barile, A.M. (2022). Effects of Mediterranean Diet Combined with CrossFit Training on Trained Adults\u2019 Performance and Body Composition. J. Pers. Med., 12.","DOI":"10.3390\/jpm12081238"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1080\/09637486.2024.2379823","article-title":"Effect of Acute Meal and Long-Term Intake of a Mediterranean Diet Providing Different Amounts of Carbohydrates on Physical Performance and Biomarkers in Non-Professional Strength Athletes","volume":"75","author":"Perna","year":"2024","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1080\/07315724.2019.1568322","article-title":"Short-Term Mediterranean Diet Improves Endurance Exercise Performance: A Randomized-Sequence Crossover Trial","volume":"38","author":"Baker","year":"2019","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1055\/a-2108-5691","article-title":"Energy and Macronutrient Intakes in Young Athletes: A Systematic Review and Meta-Analysis","volume":"45","author":"Lehmann","year":"2024","journal-title":"Int. J. Sports Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/MCO.0000000000000934","article-title":"Low Carbohydrate Availability Impairs Hypertrophy and Anaerobic Performance","volume":"26","author":"Margolis","year":"2023","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s40279-022-01757-1","article-title":"New Horizons in Carbohydrate Research and Application for Endurance Athletes","volume":"52","author":"Podlogar","year":"2022","journal-title":"Sports Med."},{"key":"ref_34","first-page":"E36","article-title":"Modern Vision of the Mediterranean Diet","volume":"63","author":"Kiani","year":"2022","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00592-010-0229-x","article-title":"Relationships between Maximal Oxygen Uptake and Endothelial Function in Healthy Male Adults: A Preliminary Study","volume":"50","author":"Buscemi","year":"2013","journal-title":"Acta Diabetol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mart\u00edn-Rodr\u00edguez, A., Belinch\u00f3n-deMiguel, P., Rubio-Zarapuz, A., Tornero-Aguilera, J.F., Mart\u00ednez-Guardado, I., Villanueva-Tobaldo, C.V., and Clemente-Su\u00e1rez, V.J. (2024). Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes. Nutrients, 16.","DOI":"10.3390\/nu16040571"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1080\/07315724.2008.10719725","article-title":"A Mediterranean Dietary Style Improves Calcium Utilization in Healthy Male Adolescents","volume":"27","author":"Seiquer","year":"2008","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/s41393-021-00682-w","article-title":"Accuracy of Bioelectrical Impedance Analysis and Skinfold Thickness in the Assessment of Body Composition in People with Chronic Spinal Cord Injury","volume":"60","author":"Ma","year":"2022","journal-title":"Spinal Cord"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"756132","DOI":"10.1155\/2012\/756132","article-title":"Oxidants, Antioxidants, and the Beneficial Roles of Exercise-Induced Production of Reactive Species","volume":"2012","author":"Gomes","year":"2012","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"17181","DOI":"10.18632\/oncotarget.24729","article-title":"Oxidative Stress: Role of Physical Exercise and Antioxidant Nutraceuticals in Adulthood and Aging","volume":"9","author":"Simioni","year":"2018","journal-title":"Oncotarget"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"O\u2019Connor, E., M\u00fcndel, T., and Barnes, M.J. (2022). Nutritional Compounds to Improve Post-Exercise Recovery. Nutrients, 14.","DOI":"10.3390\/nu14235069"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"108354","DOI":"10.1016\/j.jdiacomp.2022.108354","article-title":"Inflammation Level in Type 2 Diabetes Is Associated with Dietary Advanced Glycation End Products, Mediterranean Diet Adherence and Oxidative Balance Score: A Pathway Analysis","volume":"37","author":"Demirer","year":"2023","journal-title":"J. Diabetes Complicat."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1001\/archinte.167.11.1195","article-title":"Effect of a Traditional Mediterranean Diet on Lipoprotein Oxidation: A Randomized Controlled Trial","volume":"167","author":"Guxens","year":"2007","journal-title":"Arch. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1093\/advances\/nmaa150","article-title":"The Impact of Low Advanced Glycation End Products Diet on Metabolic Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"12","author":"Sohouli","year":"2021","journal-title":"Adv. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Gaforio, J.J., Visioli, F., Alarc\u00f3n-de-la-Lastra, C., Casta\u00f1er, O., Delgado-Rodr\u00edguez, M., Fit\u00f3, M., Hern\u00e1ndez, A.F., Huertas, J.R., Mart\u00ednez-Gonz\u00e1lez, M.A., and Menendez, J.A. (2019). Virgin Olive Oil and Health: Summary of the III International Conference on Virgin Olive Oil and Health Consensus Report, JAEN (Spain) 2018. Nutrients, 11.","DOI":"10.3390\/nu11092039"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.maturitas.2018.10.013","article-title":"Olive Oil Consumption and Human Health: A Narrative Review","volume":"118","author":"Foscolou","year":"2018","journal-title":"Maturitas"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/20\/3454\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:11:47Z","timestamp":1760112707000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/20\/3454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,11]]},"references-count":46,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["nu16203454"],"URL":"https:\/\/doi.org\/10.3390\/nu16203454","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,11]]}}}